Gold Coast Podiatry Center, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

GOLD COAST PODIATRY CENTER, LLC

Practice address

4733 N Damen Ave
Chicago, IL 60625-1442

Phone

(773) 871-2250

Fax

(773) 697-0134

NPI assigned

Mar 6, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kathy L. Julius-Buckley

Title

Managed Care Director

Phone

(773) 233-0590

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1891965786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 S WESTERN AVE",
            "address_2": "SUITE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431810",
            "telephone_number": "773-233-3800",
            "fax_number": "773-233-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4733 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251442",
            "telephone_number": "773-871-2250",
            "fax_number": "773-697-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST PODIATRY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "JULIUS-BUCKLEY",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MANAGED CARE DIRECTOR",
        "authorized_official_telephone_number": "773-233-0590",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01623607",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gold Coast Osteopathic, PSC
• Gold Coast Plastic Surgery LLC
• Gold Coast Podiatry Center, LLC
• Gold Coast Podiatry Center, LLC
• Gold Coast Podiatry Center, LLC
• Gold Coast Surgicenter, LLC
• Gold Coast Wellness Center LTD.
• Gold Management Inc
• Gold Naprapathic & Wellness Center, PC
• Gold Standard Healthcare Inc

• Foot & Ankle Surgery Podiatrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.